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A SARS-CoV-2 Negative Antigen Rapid Diagnostic in RT-qPCR Positive Samples Correlates With a Low Likelihood of Infectious Viruses in the Nasopharynx

2022; Frontiers Media; Volume: 13; Linguagem: Inglês

10.3389/fmicb.2022.912138

1664-302X

Isadora Alonso Corrêa, Débora S. Faffe, Rafael Mello Galliez, Cássia Cristina Alves Gonçalves, Richard Araújo Maia, Gustavo Peixoto da Silva, Filipe Romero Rebello Moreira, Diana Mariani, Mariana Freire Campos, Isabela de Carvalho Leitão, Marcos Romário Matos de Souza, Marcela Sabino Cunha, Érica Ramos dos Santos Nascimento, Liane de Jesus Ribeiro, Thais Felix Cordeiro da Cruz, Cíntia Policarpo, Luis Riva, Mary A. Rodgers, Michael G. Berg, Roy Vijesurier, Gavin Cloherty, John Hackett, Orlando da Costa Ferreira, Terezinha Marta Pereira Pinto Castiñeiras, Amílcar Tanuri, Luciana Jesus da Costa,

Advanced biosensing and bioanalysis techniques

Severe acute respiratory syndrome-related coronavirus (SARS-CoV-2) transmission occurs even among fully vaccinated individuals; thus, prompt identification of infected patients is central to control viral circulation. Antigen rapid diagnostic tests (Ag-RDTs) are highly specific, but sensitivity is variable. Discordant RT-qPCR vs. Ag-RDT results are reported, raising the question of whether negative Ag-RDT in positive RT-qPCR samples could imply the absence of infectious viruses. To study the relationship between negative Ag-RDT results with virological, molecular, and serological parameters, we selected a cross-sectional and a follow-up dataset and analyzed virus culture, subgenomic RNA quantification, and sequencing to determine infectious viruses and mutations. We demonstrated that RT-qPCR positive while SARS-CoV-2 Ag-RDT negative discordant results correlate with the absence of infectious virus in nasopharyngeal samples. A decrease in sgRNA detection together with an expected increase in detectable anti-S and anti-N IgGs was also verified in these samples. The data clearly demonstrate that a negative Ag-RDT sample is less likely to harbor infectious SARS-CoV-2 and, consequently, has a lower transmissible potential.